The Consolidated Appropriations Act, 2021 (CAA) required medical plans to conduct a comparative analysis of the non-quantitative treatment limitations (NQTLs) under the plan. For the first few years following the enactment of the CAA, these rules were in a proposed state; however, in late 2024 the Department of Labor (DOL), Health and Human Services (HHS), and the Treasury (IRS) (collectively, “the Departments”) released the 2024 Final Rule implementing the Mental Health Parity and Addiction Equity Act (MHPAEA). Shortly after the release of the Final Rule the ERISA Industry Committee (ERIC) filed a lawsuit in the United States District Court for the District of Columbia alleging the Departments exceeded their authority and violated regulatory and compliance frameworks established by Congress.
As a result of the litigation, the Departments requested the suit be held in abeyance while it reevaluates the Final Rule, which the court approved. Subsequently the Departments announced it would not enforce the 2024 Final Rule based on a failure to comply that occurs prior to a final decision in the litigation, plus an additional 18 months. Additionally, the Departments plan to undertake a broader reexamination of the enforcement approach under MHPAEA, including the provisions amended by the CAA.
Despite the halt on enforcement of the Final Rule and the Departments’ announcement that it intends to reevaluate the provisions outlined in the CAA, the stay is only applicable to the new requirements for compliance outlined in the Final Rule, such as the fiduciary certification requirement and specific analysis content standards. Plan sponsors are expected to continue compliance efforts with the MHPAEA NQTL requirements laid out in the proposed rules of the CAA, 2021 as these regulations remain fully in effect.
Employer Next Steps:
- Establish a fiduciary committee and create a committee charter to oversee all compliance processes and obligations established by the CAA, 2021.
- Review the obligations under the proposed rules and compile the necessary plan documents and materials needed to complete the NQTL analysis.
- Evaluate your plans using the DOL Self-Compliance Tool and engage a vendor to review your plans and conduct the MHPAEA NQTL analysis.
- Document the steps you underwent to ensure the analysis was properly completed and retain records of the analysis in case of a DOL audit.
- Continue to monitor regulatory updates. The Departments have indicated that additional guidance may be released pending their reevaluation.
